Chapter 9 | Cerebrospinal Fluid Flashcards
The functions of the CSF include all of the following except:
Producing an ultrafiltrate of plasma
The CSF flows through the:
Arachnoid space
Substances present in the CSF are controlled by the:
Blood–brain barrier
What department is the CSF tube labeled 3 routinely sent to?
Hematology
The CSF tube that should be kept at room temperature is:
Tube 2
Even distribution of blood in all tubes
Intracranial hemorrhage
Xanthochromic supernatant
Intracranial hemorrhage
Concentration of blood in tube 1 is greater than in tube 3
Traumatic tap
Specimen contains clots
Traumatic tap
The presence of xanthochromia can be caused by all of the following except:
A recent hemorrhage
A web-like pellicle in a refrigerated CSF specimen indicates:
Tubercular meningitis
Given the following information, calculate the CSF WBC count: cells counted, 80; dilution, 1:10; large Neubauer squares counted, 10.
800
A CSF WBC count is diluted with:
Acetic acid
A total CSF cell count on a clear fluid should be:
Counted undiluted
The purpose of adding albumin to CSF before cytocentrifugation is to:
D. Both A and B
Increase the cell yield
Decrease the cellular distortion
The primary concern when pleocytosis of neutrophils and lymphocytes is found in the CSF is:
Meningitis
Neutrophils with pyknotic nuclei may be mistaken for:
Nucleated RBCs
The presence of which of the following cells is increased in a parasitic infection?
Eosinophils
Macrophages appear in the CSF after:
D. All of the above
Hemorrhage
Repeated spinal taps
Diagnostic procedures
Nucleated RBCs are seen in the CSF as a result of:
Bone marrow contamination
After a CNS diagnostic procedure, which of the following might be seen in the CSF?
D. All of the above
Choroidal cells
Ependymal cells
Spindle-shaped cells
Hemosiderin granules and hematoidin crystals are seen in:
Macrophages
Myeloblasts are seen in the CSF:
As a complication of acute leukemia
Cells resembling large and small lymphocytes with cleaved nuclei represent:
Lymphoma cells
The reference range for CSF protein is:
15 to 45 g/dL
CSF can be differentiated from serum by the presence of:
Globulin
In serum, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is:
Prealbumin
Elevated CSF protein values can be caused by all of the following except:
Fluid leakage
The integrity of the blood–brain barrier is measured using the:
CSF/serum albumin index
Given the following results, calculate the IgG index: CSF IgG, 50 mg/dL; serum IgG, 2 g/dL; CSF albumin, 70 mg/dL; serum albumin, 5 g/dL.
1.8
The CSF IgG index calculated in Study Question 27 indicates:
Synthesis of IgG in the CNS
The finding of oligoclonal bands in the CSF and not in the serum is seen with:
Multiple sclerosis
A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL suggests:
Bacterial meningitis
A patient with a blood glucose of 120 mg/dL would have a normal CSF glucose of:
60 mg/dL
CSF lactate will be more consistently decreased in:
Bacterial meningitis
Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome?
Ammonia
Before performing a Gram stain on CSF, the specimen must be:
Centrifuged
All of the following statements are true about cryptococcal meningitis except:
The WBC count is over 2000
The test of choice to detect neurosyphilis is the:
FTA-ABS
Maturation of spermatozoa takes place in the:
Epididymis
Enzymes for the coagulation and liquefaction of semen are produced by the:
Prostate gland
The major component of seminal fluid is:
Fructose
If the first portion of a semen specimen is not collected, the semen analysis will have which of the following?
Decreased sperm count
Failure of laboratory personnel to document the time a semen sample is collected primarily affects the interpretation of semen:
Viscosity
Liquefaction of a semen specimen should take place within:
1 hour
A semen specimen delivered to the laboratory in a condom has a normal sperm count and markedly decreased sperm motility. This indicates:
Antispermicide in the condom
An increased semen pH may be caused by:
D. All of the above
Prostatic infection
Decreased prostatic secretions
Decreased bulbourethral gland secretions
Proteolytic enzymes may be added to semen specimens to:
Decrease the viscosity
The normal sperm concentration is:
More than 20 million/mL
Given the following information, calculate the sperm concentration: dilution, 1:20; sperm counted in five RBC squares on each side of the hemocytometer, 80 and 86; volume, 3 mL.
83 million/mL
Using the above information, calculate the sperm concentration when 80 sperm are counted in 1 WBC square and 86 sperm are counted in another WBC square.
16.6 million/mL
The primary reason to dilute a semen specimen before performing a sperm concentration is to:
Immobilize the sperm
When performing a sperm concentration, 60 sperm are counted in the RBC squares on one side of the hemocytometer and 90 sperm are counted in the RBC squares on the other side. The specimen is diluted 1:20. The:
Specimen should be rediluted and counted
Sperm motility evaluations are performed:
Within 1 hour of collection
The percentage of sperm showing average motility that is considered normal is:
50%
The purpose of the acrosomal cap is to:
Penetrate the ovum
The sperm part containing a mitochondrial sheath is the:
Midpiece
All of the following are associated with sperm motility except the:
Head
The morphologic shape of a normal sperm head is:
Oval
Normal sperm morphology when using the WHO criteria is:
> 30% normal forms
Additional parameters measured by Kruger’s strict morphology include all of the following except:
Vitality
Round cells that are of concern and may be included in sperm counts and morphology analysis are:
D. Both A and B
Leukocytes
Spermatids
If 5 round cells per 100 sperm are counted in a sperm morphology smear and the sperm concentration is 30 million, the concentration of round cells is:
1.5 million
Following an abnormal sperm motility test with a normal sperm count, what additional test might be ordered?
Eosin-nigrosin stain
Follow-up testing for a low sperm concentration would include testing for:
Seminal fluid fructose
The immunobead test for antisperm antibodies:
D. All of the above
Detects the presence of male antibodies
Determines the presence of IgG, IgM, and IgA antibodies
Determines the location of antisperm antibodies
Measurement of -glucosidase is performed to detect a disorder of the:
Epididymis
A specimen delivered to the laboratory with a request for prostatic acid phosphatase and glycoprotein p30 was collected to determine:
A possible rape
Following a negative postvasectomy wet preparation, the specimen should be:
Centrifuged and reexamined
Standardization of procedures and reference values for semen analysis is primarily provided by the:
WHO
The functions of synovial fluid include all of the following except:
Removal of cartilage debris
The primary function of synoviocytes is to:
Provide nutrients for the joints
Which of the following is not a frequently performed test on synovial fluid?
Uric acid
The procedure for collecting synovial fluid is called:
Arthrocentesis
Match the following disorders with their appropriate group:
____ Gout
____ Neisseria gonorrhoeaeinfection
____ Systemic lupus erythematosus
____ Osteoarthritis
____ Hemophilia
____ Rheumatoid arthritis
____ Heparin overdose
Noninflammatory
____ Osteoarthritis
Inflammatory
____ Gout
____ Systemic lupus erythematosus
____ Rheumatoid arthritis
Septic
____ Neisseria gonorrhoeaeinfection
Hemorrhagic
____ Hemophilia
____ Heparin overdose
Normal synovial fluid resembles:
Egg white
Before testing, very viscous synovial fluid should be treated with:
Hyaluronidase
Addition of a cloudy, yellow synovial fluid to acetic acid produces a/an:
Easily dispersed clot
Which of the following could be the most significantly affected if a synovial fluid is refrigerated before testing?
Crystal examination
The highest WBC count can be expected to be seen with:
Septic arthritis
When diluting a synovial fluid WBC count, all of the following are acceptable except:
Acetic acid
The lowest percentage of neutrophils would be seen in:
Noninflammatory arthritis
All of the following are abnormal when seen in synovial fluid except:
Synovial lining cells
Synovial fluid crystals that occur as a result of purine metabolism or chemotherapy for leukemia are:
Monosodium urate
Synovial fluid crystals associated with inflammation in dialysis patients are:
Calcium oxalate
Crystals associated with pseudogout are:
Calcium pyrophosphate dihydrate
Synovial fluid for crystal examination should be examined as a/an:
Wet preparation
Crystals that have the ability to polarize light are:
D. All of the above
Corticosteroid
Monosodium urate
Calcium oxalate
In an examination of synovial fluid under compensated polarized light, rhomboid-shaped crystals are observed. What color would these crystals be when aligned parallel to the slow vibration?
Yellow
If crystals shaped like needles are aligned perpendicular to the slow vibration of compensated polarized light, what color are they?
Negative
Negative birefringence occurs under red-compensated polarized light when:
Fast light runs against the molecular grain of the crystal
Synovial fluid cultures are often plated on chocolate agar to detect the presence of:
Neisseria gonorrhoeae
The most frequently performed chemical test on synovial fluid is:
Calcium
Which of the following chemistry tests can be performed on synovial fluid to determine the severity of RA?
Lactate
Serologic tests on patients’ serum may be performed to detect antibodies causing arthritis for all of the following disorders except:
Pseudogout
The primary purpose of serous fluid is to:
Lubricate serous membranes
The membrane that lines the wall of a cavity is the:
Parietal
During normal production of serous fluid, the slight excess of fluid is:
Absorbed by the lymphatic system
Production of serous fluid is controlled by:
D. All of the above
Capillary oncotic pressure
Capillary hydrostatic pressure
Capillary permeability
An increase in the amount of serous fluid is called a/an:
Effusion
Pleural fluid is collected by:
Thoracentesis
A. Transudate
B. Exudate
____ Caused by increased hydrostatic pressure
____ Caused by increased capillary permeability
____ Caused by decreased oncotic pressure
____ Caused by congestive heart failure
____ Malignancy related
____ Tuberculosis related
____ Endocarditis related
____ Clear appearance
A. Transudate
____ Caused by increased hydrostatic pressure
____ Malignancy related
____ Tuberculosis related
B. Exudate
____ Caused by increased capillary permeability
____ Caused by decreased oncotic pressure
____ Caused by congestive heart failure
____ Endocarditis related
____ Clear appearance
Fluid:serum protein and lactic dehydrogenase ratios are performed on serous fluids:
To classify transudates and exudates
Which of the following requires the most additional testing?
Exudate
An additional test performed on pleural fluid to classify the fluid as a transudate or exudate is the:
Fluid:cholesterol ratio
A milky-appearing pleural fluid indicates:
D. Both A and B
Thoracic duct leakage
Chronic inflammation
Which of the following best represents a hemothorax?
Blood HCT: 30 Fluid HCT: 20
All of the following are normal cells seen in pleural fluid except:
Mesothelioma cells
A differential observation of pleural fluid associated with tuberculosis is:
Decreased mesothelial cells
All of the following are characteristics of malignant cells except:
Absence of nucleoli
A pleural fluid pH of 6.0 indicates:
Esophageal rupture
Plasma cells seen in pleural fluid indicate:
Tuberculosis infection
A significant cell found in pericardial or pleural fluid that should be referred to cytology is a:
Mesothelioma cell
Another name for a peritoneal effusion is:
Ascites
A test performed primarily on peritoneal lavage fluid is a/an:
RBC count
The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the:
Serum ascites albumin gradient
Given the following results, classify this peritoneal fluid: serum albumin, 2.2 g/dL; serum protein, 6.0 g/dL; fluid albumin, 1.6 g/dL.
Exudate
Differentiation between bacterial peritonitis and cirrhosis is done by performing a/an:
Absolute neutrophil count
Detection of the CA 125 tumor marker in peritoneal fluid indicates:
Ovarian cancer
Chemical tests primarily performed on peritoneal fluid include all of the following except:
Amylase
Cultures of peritoneal fluid are incubated:
D. Both A and B
Aerobically
Anaerobically
Which of the following is not a function of amniotic fluid?
Allows carbon dioxide and oxygen exchange
What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses?
Fetal urine
Which of the following is not a reason for decreased amounts of amniotic fluid?
Fetal failure to begin swallowing
Why might a creatinine level be requested on an amniotic fluid?
Differentiate amniotic fluid from maternal urine
Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of:
Bilirubin
How are specimens for FLM testing delivered to and stored in the laboratory?
Delivered on ice and refrigerated
Why are amniotic specimens for cytogenetic analysis incubated at 37°C prior to analysis?
To prolong fetal cell viability and integrity
Fetal death
Red-brown
Normal
Colorless
Presence of bilirubin
Yellow
Presence of meconium
Dark green
A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte?
Bilirubin
Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in zone II indicates what condition of the fetus?
Moderately affected fetus that requires close monitoring
The presence of a fetal neural tube disorder may be detected by:
Increased maternal serum alpha-fetoprotein
True or False: An AFP MoM value greater than two times the median value is considered an indication of a neural tube disorder.
T
When severe HDN is present, which of the following tests on the amniotic fluid would the physician not order to determine whether the fetal lungs are mature enough to withstand a premature delivery?
AFP levels
When performing an L/S ratio by thin-layer chromatography, a mature fetal lung will show:
Lecithin twice as concentrated as sphingomyelin
True or False: Phosphatidyl glycerol is present with an L/S ratio of 1.1.
T
A rapid immunologic test for FLM that does not require performance of thin-layer chromatography is:
Aminostat-FLM
Does the failure to produce bubbles in the Foam Stability Index indicate increased or decreased lecithin?
Decreased
The presence of phosphatidyl glycerol in amniotic fluid fetal lung maturity tests must be confirmed when:
The mother has maternal diabetes
A lamellar body count of 50,000 correlates with:
OD at 650 nm of 0.150 and an L/S ratio of 2.0
In what part of the digestive tract do pancreatic enzymes and bile salts contribute to digestion?
.Small intestine
Where does the reabsorption of water take place in the primary digestive process?
Large intestine
Which of the following tests is notperformed to detect osmotic diarrhea?
Fecal neutrophils
The normal composition of feces includes all of the following except:
Blood
What is the fecal test that requires a 3-day specimen? A.Fecal occult blood
Quantitative fecal fat testing
The normal brown color of the feces is produced by:
Urobilin
Diarrhea can result from all of the following except:
Increased reabsorption of intestinal water and electrolytes
Stools from persons with steatorrhea will contain excess amounts of:
Fat
Which of the following pairings of stool appearance and cause does notmatch?
Yellow-green: barium sulfate
